Two weeks ago both the Wall Street Journal and Financial Times ran front page articles about accussations against Medco, a subsidiary of Merck & Co. over false statements and claims to the government. This is in addition to investigations of Medco over violations of anti-trust, consumer-protection and pharmacy-licensing laws by at least 25 state attorney generals. Chief federal prosecutor in Philadelphia, Patrick Meehan said: these allegations suggest that, somewhere along the line, the focus became the profit instead of the patient. (FT, June 24, 2003)
Somewhere along the line a capitalist corporation chose profit over the patient.? Stop the presses. This is scandalous. A for-profit corporation, Medco, is accused of throwing ethics out the window to focus on increasing its return on investment.
Should we be surprised that much of medicine is driven by much the same interest as the rest of our profit driven economy? If we are, it is only because we project our values that medicine is about healing and nurturing onto the medical industry. We forget that the only reason today’s medical establishment appears even slightly humane is as a result of struggles by ordinary people for regulations of medical practices. We overlook the fact that the medical industry, like capitalist enterprise in general, is structured to make a buck no matter the human, social or ecological costs.
Medical companies turn a blind eye to products that kill.
Two weeks ago, Guidant Corp, one of the largest makers of medical devices plead guilty to 10 felonies, admitting it lied to government and hid thousands of serious health problems, including 12 deaths, caused by one of its products (N.Y. Times June 13). In late May, the N.Y. Times reported that during the mid 1980s the pharmaceutical company Bayer sold millions of dollars of blood-clotting medicine for hemophiliacs, medicine that carried a high risk of transmitting AIDS, to Asia and Lain America. They sold the potentially deadly product for over a year while selling a new, safer product in the West. (May 22)
Medical corporations cheat the government whenever possible.
Tenet healthcare stocks dropped by 26% down to $12 from a high of $50 in October. The reason is that Tenet is under investigation since, much of its profitability in recent years stemmed from special payments from Medicare. By pursuing a policy of aggressively raising prices at some of its hospitals, Tenet enjoyed an unusual amount of these special payments. (N.Y. Times, June 24)
Private hospitals take advantage of the less powerful.
American hospitals regularly bill the uninsured at a higher rate than the insured for the same treatment. According to K.B. Forbes with the uninsured lobby group Consejo de Latinos Unidos, Tenet Healthcare Corp., the USA’s second largest hospital chain, charges uninsured patients three to 10 times more than HMOs. (Wall Street Journal, June 19)
Hospital companies push governments to privatize no matter the human cost.
The business friendly Liberal government in British Columbia (Canada) is currently attempting to privatize public hospitals. Even though, recent studies in both the Canadian Medical Association Journal and the Journal of the American Medical association show that patients are more likely to die prematurely in private, for-profit hospitals and clinics than in not-for-profit settings (Globe and Mail June 16).
Medical industry compassion is all about financial necessity.
The surge in medical malpractice claims has one good side effect. It’s getting easier to register complaints about poor care and demand answers about an unexpected injury or death. The reason is studies show that a majority of malpractice suits are brought not necessarily because of a bad outcome in treatment but because patients and their families felt medical staff either lied about it or tried to stonewall them afterward. (Wall Street Journal, June 19) HMOs after years of being attacked for setting up obstacles to patients access to specialists and medical tests, have decided to press patients to get more tests and see specialists. The goal: to coax, cajole and nag patients into seeing doctors, filling prescriptions and generally taking better care of themselves. The idea is that a healthier patient will be a cheaper patient, even if it costs extra money upfront. (Wall Street Journal, June 17)
Pharmaceutical companies thrive on conspicuous consumption.
Drug companies lobby for unrestricted ability to promote their products, no matter the health effects. Currently, big Pharma is pressuring the Canadian and European governments to fully de-regulate direct-to-consumer drug advertising as is the case in the US. Even though evidence shows that DTC ads create pressure on doctors to prescribe and that they harm the doctor/patient relationship. Similarly, they increase the consumption of drugs, which has little positive correlation to human well-being. Americans for example, are the biggest pill poppers in the world yet they die younger than inhabitants of every other industrialized nation (by chance the US is the industrialized country with the largest capitalistic focus within the health establishment, not to mention society in general.)
Life saving health resources are only for those who can pay.
Every year 14 million people die from disease for which medicines exist but are inaccessible (National Post, June 2).The French company, Aventis, which in 1995 suspended production of a substance that was effective against sleeping sickness on the grounds that it was not profitable, has relaunched it after discovering that it was also effective in removing women?s facial hair. (Guardian Weekly, June 5)
Medical research focuses on what is profitable.
There is a serious global inequality of health resources. Public health officials use the term the 10/90 gap. In effect, the wealthiest 10% of the world receives 90% of all health research spending, while the poorest 90% only receives 10%. According to MSF [Medecin Sans Frontieres], neglected diseases, which threaten the lives of tens of millions of people, mainly in Africa, accounted in 2002 for less than 0.001% of the $60-70bn spent a year on medical research throughout the world. (Guardian Weekly June 5) According to the profit motive 90% of humanity is of little value.
So long as capitalist interests dominate the medical establishment, profitability not human well-being will drive the system. As the once respectable heavy group Metallica put it, this is sad but true.
yves engler is a montreal based activist currently working on a book about student activism at Concordia University. He can be reached at [email protected]